Cancer care in Delhi far from satisfactory
Naila Laiq, 32, died of cancer in 2004. A resident of Old Delhi’s Chandni Chowk, she was diagnosed with breast cancer at age 29. After undergoing two surgeries and spending Rs 70,000, she recovered. But the joy was short-lived as the disease resurfaced in the form brain tumour. “Specialists at one of Delhi’s renowned cancer hospitals failed to diagnose the problem on time,” said Naila’s aunt Shams Parveen.
South Delhi’s Vidyasagar Institute of Mental Health and Neurosciences (VIMHANS), a private hospital, confirmed the tumour. But it was too late. “Thanks to the callousness of the oncologist, the treatment had been delayed. Doctors had given up on her, but we wanted her to live even if it was for a month. VIMHANS demanded Rs 4 lakh for the surgery and Rajiv Gandhi Cancer Institute and Research Centre [another private hospital] Rs 3 lakh. But neither of them assured us that she would live,” said Shams. Even when cancer took away Naila’s life, the cost of treatment is taking its toll on her parents.
According to a report by Dr B.R.A. Institute Rotary Cancer Hospital (IRCH) and Delhi Cancer Registry, more than 10,000 cancer cases were reported in Delhi in 2003. But the state has just four government-run hospitals that handle cancer cases, and half the patients depend on them. While these hospitals are unable to cater to the demand, treatment at private hospitals costs a bomb. “Government hospitals had a long waiting list, and Naila’s state was serious. At Rajiv Gandhi hospital we weren’t even offered a seat. Naila had to wait in her wheelchair while the doctors told us that they would give us time only if we planned to get her operated there,” said Shams.
Getting cancer treatment at Delhi’s government-run hospitals like All India Institute of Medical Sciences, Safdarjung Hospital, Lok Nayak Jai Prakash Narayan Hospital and Guru Tegh Bahadur Hospital is arduous. Sources say that patients have to wait for three to four months to get an appointment with a doctor.
Said Dr Praveen Garg, senior consultant of surgical oncology at privately-run Batra hospital: “Thanks to the long list of VIP patients, the rest are left to die a painful death. While our staff works from 8 a.m. to 11 p.m., officials in government hospitals aren’t willing to work after 2 p.m. We need more cancer detection centres in Delhi, but I fear it may just add to the problem. When we aren’t able to handle the present cases, how do we expect to tackle another 10,000?”
But according to Dr G.K. Rath, director, IRCH, AIIMS, the problem lies somewhere else. “Every year government hospitals and patients all over India together spend Rs 27,700 crore on just tobacco-related cancer diseases. Still it is not enough. The IRCH has 185 beds and caters to 8,000 patients every year. The waiting period is three to four weeks. The treatment here is cost effective and open to anyone who can’t afford the treatment.” The cost of surgery is Rs 1,200 and in general ward it is free. The hospital provides radiotherapy for Rs 750 a day. “It is cheap compared with private hospitals. But most patients who turn up here initially, move to private hospitals due to impatience,” said Rath.
Patients say the long-winding procedures for getting subsidised treatment are a put-off. Manpreet Singh, 20, was diagnosed with acute myeloid leukemia at IRCH and has spent Rs 4 lakh in the last six months on treatment. Said Manpreet: “We didn’t apply for free treatment as it takes a lot of time and I think it’s only for those who are very poor.”
Son of a businessman, he is disheartened with the way things are done in the hospital. “The doctors give us just five minutes during consultation. Things like syringes and glucose are what they provide us free of cost. When I can spend Rs 40,000 on buying Cytosar, one of the most expensive medicines, I can obviously buy syringes on my own. My father has exhausted all his savings on my treatment. But I have no option as I can’t afford hospitals like Rajiv Gandhi hospital or Apollo.”
A renowned oncologist in a government hospital in Delhi acknowledges the lack of adequate medical infrastructure. “India is not equipped to cater to nine lakh cancer cases every year, with 75 per cent being reported in advanced stages. We have just 25 regional cancer centres and we need 1,000 more. We are in desperate need of trained doctors in oncology and good surgical, radiation and medical equipment,” he said.
In such a mess, the biggest sufferers are patients who come from nearby states expecting good treatment in the capital. Delhi Cancer Support Societies say most of the outstation patients do not know where to go. NGOs like Indian Cancer Society work in tandem with the IRCH and Safdarjang Hospital and find out who needs what kind of help. “We work out this help through the Prime Minister’s Relief Fund and other donations. All this is mostly for people who are below the poverty line. We help out patients from the middle class, too, but it’s mostly the doctors who take a call on this,” said Usha Uri of Indian Cancer Society.
No matter how hard these NGOs try, most cancer patients from the middle class continue to suffer because of insufficient funds and lack of latest technology at state-run cancer hospitals. Said Sammer Kaul, senior surgical oncologist, Apollo Cancer Institute: “At a private hospital like ours… we try to save the affected breast by using a port. We give chemotherapy through the port but this is very expensive. Ordinary government hospitals do not have this facility and even if they have it, there’s a long queue.”
Apart from this, expensive drugs like Herceptin that affect only the cancer-affected cells aren’t easily available at most hospitals. “Drugs like these ensure better survival chances, are imported and cost nothing less than Rs 2 lakh. Technologies like IMRT radiation and other ?high-end machines are not maintained properly at these hospitals,” said Kaul.
Dr R.P. Vashisht, cancer control officer with Delhi’s National Cancer Control Programme, is optimistic that things will change. “The coming up of State Cancer Institute is the first step. It came into existence last year,” he said. Once this project is successful, we will introduce more hospitals like this. People who have the know-how of operating advanced machines move to the private sector. The kind of pay packages they get there can’t be matched easily.”
The agony of cancer patients in Delhi does not end here. Said Sneha Sharma, 19, a Hodkin’s Lymphoma patient: “You have to be very smart to get your work done at these cancer hospitals. [A private hospital] has a very good transplant unit but the attitude of the authorities is very disappointing. The atmosphere is gloomy with some patients getting their chemos done on stretchers in the lobby. The nursing staff doesn’t listen to you. You have to scream and shout at them. You wait for more than a week to get an appointment and the discharge procedure is equally tedious.” Only more hospitals can solve these problems.
Source : Week Magazine